Invisible Hand-Rights of Nature Screening - Visitor Vaccination Attestation Form

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Wesleyan University requires all visitors to be fully vaccinated including receiving a booster dose before entering the campus to reduce the risk of COVID for all students, faculty, and staff.

I attest that I am fully vaccinated (two weeks beyond the last dose of a two dose vaccine series or two weeks beyond one dose of a single-dose vaccine that is approved by the WHO). If it has been six months since my final dose, I have also received a COVID19 booster dose as recommended by the CDC.

Email *

Name of Visitor: *

Date of last vaccination received: *

YYYY

By checking this box, I attest that I am fully vaccinated, as described above. *

I am vaccinated

Required

Date: *

YYYY

A copy of your responses will be emailed to the address you provided.

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